Immunohistochemical detection of p53 protein could improve the management of some patients with Barrett esophagus and mild histologic alterations.

Abstract Objective.—To determine the usefulness of p53 immunostaining in identifying the subgroup of patients with Barrett esophagus who may be at increased risk of developing adenocarcinoma of the esophagus. Materials and Methods.—Tissue samples of 41 patients with Barrett esophagus and available sequential histologic data were processed for p53 immunostaining. Results from each patient were compared over time, and the results of a subset of patients were compared with each other. Results.—We observed a significant correlation between the percentage of samples with p53 expression and the severity of dysplasia. Moreover, in a subset of patients with mild dysplasia (cases classified as showing indefinite dysplasia), we observed a statistically significant difference in the percentage of p53-positive samples between the group that progressed to more severe dysplasia and the group that did not progress. Conclusion.—Our results suggest that this procedure, which is technically simple, economical, and quick, c...